Gallery: Medical care on the frontlines in Iraq

28 July 2016

This mini photo essay depicts the daily lives of Iraq’s internally displaced people (IDPs) stranded between the governorates of Erbil and Ninewa in camps and communities located only a dozen or so kilometres away from the city of Mosul, the stronghold of the Islamic State group (IS). It showcases the suffering of the IDPs and the efforts undertaken by MSF teams in the frontline regions of Hawira and Debaga to alleviate people's sorrow.

Photo: Mirella Hodeib/MSF

The mobile clinic set up by MSF in the village of Hawira, a few dozen kilometres away from IS-occupied Mosul, was packed on 24 July. Over 100 consultations were undertaken, mainly people presenting with non-communicable/chronic diseases. Diabetes is prevalent among the patients, whose living conditions and frequent mobility due to the raging war in Iraq, directly impacts their health and lifestyle. The mobile clinic team hopes that with the introduction of health promotion activities starting in August, patients will better be sensitised to healthy practices.

Photo: Mirella Hodeib/MSF

“If we don’t have a space, we create one”, says Paula, an MSF psychiatrist. MSF’s mental health team is made up of a psychiatrist, Paula, a psychologist, Khawla, and an interpreter, Adnan, and they are part of the mobile clinic that visits Hawira once every 15 days. Paula says that the real challenge lies in adapting treatments to mental health ailments that are largely related to the difficult security context in Iraq.

“What treatment would you give to a patient who has seen someone being decapitated in front of them?” she asks. “Most people suffer from insomnia or have recurrent nightmares of the traumatising episodes they have lived through.” Paula helps them get better sleep. “If they are able to improve their sleep they can better cope with the difficult situations they are going through.”

For Khawla, the stigma that has long been related to all mental health matters is slowly fading as Iraqis become more accepting and open to the mental health services provided by MSF. “Everyone in Iraq is under tremendous pressure and they understand the need to seek some help in order to decompress”, says Khawla. The mental health team undertakes eight to nine consultations per day, which last between 30 to 45 minutes. The most common ailments are anxiety, depression, and post traumatic stress disorder (PTSD).

Photo: Mirella Hodeib/MSF

Dr Ali, the Medical Activity Manager, comforts patients who are waiting in the reception area of MSF’s mobile clinic in Hawira. He informs them that they will all be able to seek the advice of a physician. MSF’s mobile clinic, which receives patients from Hawira and the surrounding villages, visits the area every two weeks.

Photo: Mirella Hodeib/MSF

Dr Anmar explains to one of his patients about their medical condition. Originally from Mosul and hailing from a family of physicians, Dr Anmar and his wife and mother fled to Erbil in Iraqi Kurdistan when the IS group took over his hometown. “Mosul is a city that has long supported education and stood against obscurantism”, he said during a break in his long day of consultations.

Photo: Mirella Hodeib/MSF

On 24 July, three-year-old Zina was the youngest patient at MSF’s mobile clinic in Hawira. Her tiny head is wrapped in bandages as the team have performed a small surgery to remove an infected polyp. Zina suffers from hydrocephalus, epilepsy and blindness which are all the result of a birth defect. Hydrocephalus leads Zina to develop polyps all over her head and they easily get infected.

Photo: Mirella Hodeib/MSF

On Sunday 24 July, the MSF mobile clinic in Hawira was crowded. Dr Ali struggled to find a space to examine the flood of patients. “You have to adapt”, he explained. Before adding “We are actually lucky today”. “We are working under a roof with some air-conditioning. Sometimes we have no choice but to erect the clinic in the open air with no tent to shield us and when it is 50 degrees Celsius in the shade.”

Photo: Mirella Hodeib/MSF

Five-year-old Samah dropped by the MSF mobile clinic for her mother’s regular check-up. Samah’s mother suffers from hypertension and tachycardia. Her condition has worsened ever since her mother and siblings, one sister and two brothers, were left stranded in IS-occupied Mosul. “Every time I think of my family I become very sick”, Um Samah said, her eyes welling with tears. “I feel pain in my heart.”

Photo: Mirella Hodeib/MSF

Dr Ali had to perform an urgent surgery on Zina, a three-year-old patient suffering from hydrocephalus, epilepsy and blindness. Zina’s mother who is also a patient of the mobile clinic in Hawira, suffers from diabetes. Alarmingly, on Sunday, her blood glucose level stood at over 500 mg. Dr Ali advised her to cut down on carbohydrates, including rice and bread, and replace them with vegetables and legumes. “But how will I ever feel satiated if I don’t eat bread?!” Um Zina asked.